PETER CAVE: Watching surgeons operate on patients may once have been an acceptable spectacle but the popularity of the pastime has waned in recent centuries.

The ethical issues around the practice have now been thrown into the spotlight though after revelations that a prominent Sydney surgeon has auctioned off tickets to watch him at work.

Public health advocates and the Royal College of Surgeons say it raises serious questions about consent and privacy.

Meredith Griffiths reports.

MEREDITH GRIFFITHS: Brain surgeon Charlie Teo was made a Member of the Order of Australia this week but it's his actions a few months ago that are getting the attention now.

At a charity auction in October Dr Teo gave people the chance to watch him work.

Public health professor Simon Chapman from Sydney University was at the auction. He says it's an unethical thing to do even if the patients give consent.

SIMON CHAPMAN: If you're a patient who is undergoing a very serious procedure such as brain surgery for cancer and you're in the hands if you like of a leading surgeon and the surgeon makes that request of you, there is an inherent power imbalance there.

Yes you can consent. You can say yes that's fine. But what if you had reservations? What if you didn't want your privacy invaded like that? Would you really be able to say no, look I'd rather not? Would you feel awkward about that? Would you feel you were letting the surgeon down, that he may think ill of you somehow? You probably would think twice about saying no.

MEREDITH GRIFFITHS: But Dr Teo is saying that's not an issue because he develops quite strong friendships with his patients.

SIMON CHAPMAN: I'm sure Dr Teo has strong views about the people concerned. But I mean bioethics is not down to the person making the call. I mean there are standards, there are arguments, there are ethical principles which need to be considered in the cool light of day.

A very obvious other example is in professions particularly for example teachers or doctors, a lot of debate about whether those pupils or patients can consent to have sexual encounters with doctors or teachers.

And the answer is plainly no, that they can't even if they say that they wish to consent to do so. But the professions involved there say it doesn't really matter. It's irrelevant if the patient consents; that line should not be crossed.

MEREDITH GRIFFITHS: The Royal Australasian College of Surgeons will investigate whether Dr Teo or the hospital breached ethical guidelines

Dr John Quinn is the college's executive director of surgical affairs.

JOHN QUINN: Well the college feels that this activity of surgery for viewing at a price is unacceptable really.

It's not a, surgery is not a spectator sport. It's a really quite a serious activity and often a life or death situation. And viewing live surgery is not regarded as appropriate behaviour.

MEREDITH GRIFFITHS: What kind of action could you take? Would the doctor or the hospital face any kind of punishment?

JOHN QUINN: Well the college doesn't have any authority over hospitals. The public hospitals are under the direction, guidance and control of the health departments in the various states.

The college does have a code of conduct which all fellows and trainees in surgery of the College of Surgeons are expected to abide.